VIE: Second Health Care in the Central Highlands Project in Dak Nong Province

Transcription

1 Due Diligence Report March 2016 VIE: Second Health Care in the Central Highlands Project in Dak Nong Province Prepared by the Ministry of Health, Socialist Republic of Viet Nam, for Asian Development Bank. The Due Diligence Report is a document of the borrower. The views expressed herein do not necessarily represent those of ADB's Board of Directors, Management, or staff, and may be preliminary in nature. In preparing any country program or strategy, financing any project, or by making any designation of or reference to a particular territory or geographic area in this document, the Asian Development Bank does not intend to make any judgments as to the legal or other status of any territory or area.

2 CURRENCY EQUIVALENTS (as of Mar, 2016) Currency unit Vietnamese Dong (VND) $1.00 = VND 22,350 ACCRONYMS ADB - Asian Development Bank CHS - Commune Health Station CPMU - Central Project Management Unit EGP - Ethnic Group Plan HICH - Health Care in the Central Highlands Project IEC - Information, Education and Communication ICP - Inter-communal Polyclinics IMR - Infant Mortality Rate MDG - Millennium Development Goal MMR - Maternal Mortality Ratio MOH - Ministry of Health MOF - Ministry of Finance NGO - Non-Government Organization PAM - Project Administration Manual PCR - Project Completion Report PHC - Primary Health Care PPMU - Provincial Project Management Unit U5MR - Under-five mortality Rate VHW - Village Health Worker VSS - Vietnam Social Security System

3 I. INTRODUCTION 1. The Ministry of Health (MOH) is implementing the Second Health Care in the Central Highlands Project (HICH, or the Project) in the 5 provinces (Dak Lak, Lam Dong, Gia Lai, Kom Tum and Dak Nong) of Viet Nam, through Loan 3038 VIE (SF) from the Asian Development Bank (ADB). The objective of the Project is to increase use of maternal and child health services in district hospitals, inter-communal polyclinics (ICPs) and commune health stations (CHSs) by: (i) building new, upgrading some CHSs, ICPs and district hospitals including WWTPs, (ii) providing medical equipment and HMIS at the central, provincial, district, commune and village levels, (iii) developing human health resources through long-term and short-term training courses in professional and managerial skills and (iv) service access support. 2. The Project comprises the following components in the Target Provinces: Component A: Improved Access and Quality of Community Health Care Component B: Increased Access and Quality of Hospital Services Component C: Strengthened Provincial Health System Management 3. The safeguard categories for the Project is as below: Environment category B: Anticipated disturbance during construction and generation of wastes during operation of hospitals. Involuntary Resettlement category C: No resettlement issues have been identified or are expected. Indigenous Peoples category B: The project includes a significant proportion of ethnic groups amongst its beneficiaries in the targeted provinces, who are among some of the poorest and most marginalized households in Viet Nam. 4. Dak Nong is located in the center of the central highland is one of the Target Provinces that shares borders with three Vietnamese provinces as Dak Lac, Lam Dong and Binh Phuong and with Cambodia on the west. Dak Nong has an area of 6,515.6 km 2 with the population of people in 2014 of which the Kinh accounts for 69 percent and 31 percent remaining comprises 40 ethnic groups as the E De, M'nông, Ma, Tày, Nùng. 5. The Project shall finance for construction and upgrading of 10 Community Health Stations (CHSs) located in 10 communes of Dak Nong Province as Duc uyen, Quang Hoa, Quang Son, Quang Tuan, Nghia Thang, Dak Buso, Duc An, Thuan Hanh, Eatling, and Nam Dong, upgrading of a district hospital in Dak R Lap District consisting of construction of a wastewater treatment plan (WWTP) and a 2-storey building 6. The objective of the DDR is to confirm if all the safeguards-related conditions in the Loan Agreement have been met by the respective stakeholders to allow the issuance of no objection for the award of civil works contract for the construction and upgrading works of the Project in Dak Nong Province. Specifically, the DDR will:

4 a. Verify if (i) DONRE has granted the final approval of the IEE, (ii) MOH and the PPMUs have incorporated relevant provisions from the EMP (including monitoring and reporting requirements) into the bidding documents and works contract, and (iii) DONRE has issued the required certificates of environmental protection or environmental impact assessment certificates for civil works contracts that involves environmental impacts; b. Verify if the proposed civil works (hospitals and community health centers) will not involve any land acquisition or involuntary resettlement impacts. In doing so, determine the current use, type and ownership of the land where the facilities will be constructed, sufficiency of available land for the civil works, including sites for temporary use during construction; c. Ascertain which ethnic minority groups are within the service-area of the proposed facilities, and assess how they are covered in the final ethnic minorities development plan (EMDP), which is also a requirement for awarding works contract; 7. While in the field, the consultant is also expected to advise the PPMUs of the other safeguards-related requirements during project implementation as provided in the loan agreement to ensure their awareness of such requirements. 8. Prior to the field visit, the CPMU prepared the checklists for screening involuntary resettlement, environment and indigenous peoples impacts (see appendix 1). The checklists were sent to Dak Nong PPMU to assist the PPMU in verifying the status of safeguard issues of the subproject in Dak Nong. The field visit was undertaken by the safeguard specialist on Dec 2015 to review the report prepared by the Dak Nong PPMU, consult the PPMU on the corrective and pending actions and collect necessary information and documents needed for the preparation of the DDR. During this trip, all the proposed works were visited. Meetings with the PPMU, the project owners and the environmental consultant of PPMU were organized. Findings from the visit are presented in the succeeding sections. II. THE PROPOSED WORKS 9. The proposed civil works in Dak Nong includes the construction and upgrading of 10 CHSs in 10 communes, upgrading the treatment capacity and construction of a WWTP for Dak R Lap In Dec 2015, all technical designs for the said proposed works have been completed and approved by Dak Nong People Committee and biding documents have been preparing. A brief description on the existing CHSs and hospital that are financed by the project is presented in Table 1. Table 1. Description of existing CHSs and hospital Location/ Commune Year of opeartion Current Area (m2) Existing physical facilities Duc uyen A single-storey grade IV building with 4 rooms (80m2), an incinerator

5 Quang Hoa A single-storey grade IV building with 5 rooms (90 m2), an incinerator Quang Son ,3 A single-storey grade IV building with 4 rooms (80 m2), an incinerator Quang Tan two single-storey grade IV buildings with 4 rooms (80 m2), an incinerator Nghia Thang two single-storey grade IV buildings with 5 rooms (95 m2), an incinerator Dak Buso three single-storey grade IV building with 11 rooms (150 m2), an incinerator Duc An A single-storey grade IV building with 5 rooms (90 m2), an incinerator Thuan Hanh two single-storey grade IV buildings with 5 rooms (110 m2), an incinerator Eatling A single-storey grade IV building with 4 rooms (80m2), an incinerator Nam Dong two single-storey grade IV building with 11 rooms (120 m2), an incinerator Dak R Lap Two two-storey buildings, a singlestorey building with treatment capacity of 100 beds, a parking house, an incinerator, no WWTP. 10. The location, description of the proposed works, area required, current land use of the sites and land ownership status of the proposed works sites in Dak Nong province are presented in table 2. Table 2. Description of the proposed works and sites in Dak Nong Province Location Duc uyen Quang Hoa Quang Son Proposed Work Description A Health station building a single-storey building with 11 rooms. Const Area (m 2 ) WC house 18 Parking yard 48 A Health station building a single-storey building with 11 rooms A service house 74 WC house 19,8 Parking yard 75,6 A Health station building a single-storey building with 8 rooms. Current Land Use 256 A proposed works are constructed within the campus of the current heath station. 290 Idle area with some small trees and bushes. No agricultural activities, no housing on this area. 219,65 A proposed works are constructed within the campus of the current CHS Holder of LURC Duc uyen Health Station Quang Hoa Commune Quang Son Health Station Rehabilitation of existing 144 building up to 6 rooms Parking yard 59 Dak Buso A Health station building a 250 Idle area with only Dak Buso

6 Location Quang Tan Nghia Thang Duc An Thuan Hanh Eatling Nam Dong Dak R Lap Proposed Work Description Const Area (m 2 ) Current Land Use single-storey building with 11 bushes, No agricultural rooms activities, no housing on A service house 74 this area. WC house 18 Parking yard 48 Rehabilitation of existing 428 Idle area, on this area health station there is an abandoned 1 Rehabilitation of existing 144 storey building that was administration house used as school. Parking yard 59 A Health station building a 250 Idle area, on this area single-storey building with 11 there is an abandoned 1 rooms A service house 74 WC house 19.8 Parking yard 75.6 A Health station building a single-storey building with 11 rooms A service house WC house storey building that was used as kindergarten. 250 Idle area with some small trees and bushes. No agricultural activities, no housing on this area. Parking yard A Health station building a 170 A proposed works are single-storey building with 11 constructed within the rooms campus of the current Rehabilitation of existing 110 health station administration house A service house WC house A Health station building a 287,63 Idle area with only single-storey building with 11 bushes located near Cu rooms Jut district hospital A service house 19,84 WC house 19,84 Parking yard 66,78 A Health station building a single-storey building with 11 rooms Rehabilitation of existing 68 building Service house 74 WC house 19.8 Parking yard 75.6 A New Wastewater treatment plant with capacity of 200 m3/day Construction of a new treatment ward 2-storey 260 A proposed works are constructed within the campus of the current health station 200 A proposed works are constructed within the campus of the current district hospital 300 Holder of LURC Commume Quang Tan commune Nghia Thang commune Duc An commune Thuan Hanh health station Eatling Health station Nam Dong health station Dak R Lap district hospital

7 Location Proposed Work Description building Rehabilitation of a existing single storey building Const Area (m 2 ) 120 Current Land Use Holder of LURC III. POTENTIAL SAFEGUARD ISSUES OF THE SUBPROJECT IN DAK NONG PROVINCE 11. Land Acquisition and Resettlement: after reviewing the technical design, taking site visits and collecting the documents related to land use rights, it is concluded that no resettlement issues have been identified or are expected. The details are presented as below (see Appendix 3 for the pictures of the sites): Duc uyen Health Station: all construction works are in the campus of the existing Health Station, the total construction area of 300 m 2 for a new building, a WC house and a parking yard that is currently used as internal roads, yard and garden of the station. The station also holds the certificate of land-use right No R issued on 10th July 2001 by Dak Nong Province People Committee. No land acquisition is required and no third-party user will be affected. Quang Hoa Health Station: shall be relocated to new place that is, currently, an idle area on which there are only bushes. This area used to belong a local household (Mr Nguyen Van Binh) and was recovered in 2013 based on the decision 2789/QD-UBND on approval of compensation and clearance for the construction of Quang Hoa Health Station issued by Dak Glong District Pepole Committee on 07 Aug Mr Nguyen Van Binh and his wife were received more than VND for land, trees and other supports in 21 Nov 2013 (the safeguard specialist had a meeting with the wife of Mr Binh at her home and she confirmed that they had agreed with the compensation plan of the District, for reference see more in appendix 2 Minutes on compensation payment with signatures of Mr Binh and his wife). Since this time the land was kept idle waiting for the proposed work, still under management of the District and No third-party user has been affected Quang Son Health Station: all construction works are in the campus of the existing Health Station, the total construction area of 270 m 2 for a new building and a parking yard that is currently used as internal roads, yard and garden of station. The campus of station is m 2 surrounded by fences and the station has been operating for 15 years without any grievance on land use. This is confirmed by an official minutes on land handover among Quang Son people committee, Quang Son Health Station and two local households sharing the land borders with the station on 25 Mar 2015, the safeguard specialist also consulted Mrs Tran Thi Viet, one of the two local households to confirm on this issue. No land acquisition is required and no third-party user will be affected. Dak Buso Health Station: shall be relocated to new place that is, currently, an idle area on which there are only bushes, small trees growing wildly all over. This area was under management of Dak Buso People Committee since it had been

8 reclaimed and was handover to Tuy Duc Preventive Health Center, management unit of Dak Buso Health station, for construction of a new health station based on an official minutes on land handover among Tuy Duc district people committee, the preventive health center and Dak Buso people committee on 18 May There is no history of agricultural activities or living on this area, No land acquisition is required and no third-party user will be affected. Quang Tan Health Station: shall be relocated to new place that is, currently, an idle area on which there are an abandoned single-storey school of 150 m 2, degraded school yard, and some trees for shade and bushes. This area once was a primary school until Aug 2013 when a new larger ones combined primary and secondary school, was built that is 100 m far from old ones. Since that, the area is handover to Dak Nong Department of Health based on Decree 1342/QD- UBND on 27 th Aug 2013 issued by Dak Nong Province People Committee for construction of new health station. No land acquisition is required and no thirdparty user will be affected. Nghia Thang Health Station: shall be relocated to new place that is, currently, an idle area on which there are an abandoned single-storey kindergarten of 30 m 2 and bushes. This area once was a kindergarten until May 2014 when a new larger ones was built that is 200 m far from old one. Since that, the area was recovered from the management of Kindergarten (the director of kindergarten had sent an official letter to Dak R lap district people committee to return this area after relocating on the new area) and is handover to Nghia Thang Health Station for constructing a new station based on an official letter No 432/UBND dated 27/06/2014 issued by Dak R Lap district people committee to Dak Nong Province People Committee and Dak Nong DONRE. No land acquisition is required and no third-party user will be affected. Duc An Health Station: shall be relocated to new place that is, currently, an idle area on which there are only bushes, small trees growing wildly all over. This area was under management of Duc An People Committee since it had been reclaimed and has been planned for the new health station based on an official land map excerpt issued by Duc An town people committee on 13 May No land acquisition is required and no third-party user will be affected. Thuan Hanh Health Station: all construction works are in the campus of the existing Health Station, the total construction area of 250 m 2 for a new building, a services house and a WC house that is currently used as internal roads, yard and garden of the station. The campus of station is 987 m 2 surrounded by fences and the station has been operating since 2003 without any grievance on land use. An official land map excerpt issued by Thuan Hanh People Committee on 29 August 2008 also confirms on this issue. No land acquisition is required and no thirdparty user will be affected. Eatling Health Station: shall be relocated to new place that is, currently, an idle area on which there are only bushes growing wildly all over. The station also holds the certificate of land-use right No BU issued on 21 st Aug 2014 by Dak Nong Province People Committee for 1707m2 of this area. No land

9 acquisition is required and no third-party user will be affected. Nam Dong Health Station: all construction works are in the campus of the existing Health Station, the total construction area of 420 m 2 for a new building, a services house, a WC house and a parking yard that is currently used as internal roads, yard and garden of the station. The station also holds the certificate of land-use right No TD issued on 6th Dec 2006 by Dak Nong Province People Committee for the area on which the station is located. No land acquisition is required and no third-party user will be affected. Dak R lap district hospital: all construction works are in the campus of the existing hospital, the total construction area of 500 m 2 for a new building, a WWTP that is currently used as internal roads and yard of the hospital. The station also holds the certificate of land-use right No HB issued on 18th Nov 2007 by Dak Nong Province People Committee for the area on which the station is located. No land acquisition is required and no third-party user will be affected. 12. Environment: The proposed works are expected to have positive impacts to the environment as these will support the construction, rehabilitation, and operation of health facilities, including improvement in water, sanitation, and waste management systems. However, the construction activities will cause disturbances. Such impacts which include generation of noise and dust, deterioration of water quality through sediment laden runoff or improper waste disposal, exacerbation of local flooding conditions, and disruption to property access or commercial activities, will be readily managed to acceptable levels through implementation of standard construction environmental management practices. The current environmental status is described in table 3. Table 3. The current environmental status of the proposed works in Dak Nong province Proposed works Duc uyen Waste water water Currently using septic tank for WC house. Solid waste treatment Solid wastes of the station mostly plastic syringe, packings of medicine are collected each day and then are burned by an incinerator Required environmental reports and approval for proposed works A simple environmental protection plan is required according to the decree 18/2015/ND-CP. This plan had been prepared by Dak Nong PPMU and submitted to the DONRE for approval on 2 nd Dec 2015 (the note issued by Dak Nong DONRE for receiving report is The relevant EMP is incorporated into bidding documents and work contract Yes. Referred to in item 24 chapter A, Section 7 of the bidding document and annex 1 of the works contract

10 Proposed works Quang Hoa Quang Son Dak Buso Waste water water Currently using septic tank for WC house. Currently using septic tank for WC house. Currently using septic tank for WC house. Solid waste treatment Solid wastes of the station mostly plastic syringe, packings of medicine are collected each day and then are burned by an incinerator Solid wastes of the station mostly plastic syringe, packings of medicine are collected each day and then are burned by an incinerator Solid wastes of the station mostly plastic syringe, packings of medicine are collected each day and then are burned by an incinerator Required environmental reports and approval for proposed works enclosed in appendix 4) A simple environmental protection plan is required according to the decree 18/2015/ND-CP. This plan had been prepared by Dak Nong PPMU and submitted to the DONRE for approval on 2 nd Dec 2015 (the note issued by Dak Nong DONRE for receiving report is enclosed in appendix 4) A simple environmental protection plan is required according to the decree 18/2015/ND-CP. This plan had been prepared by Dak Nong PPMU and submitted to the DONRE for approval on 2 nd Dec 2015 (the note issued by Dak Nong DONRE for receiving report is enclosed in appendix 4) A simple environmental protection plan is required according to the decree 18/2015/ND-CP. This plan had been prepared by Dak Nong PPMU and submitted to the DONRE for approval on 2 nd Dec 2015 (the note issued by Dak Nong DONRE The relevant EMP is incorporated into bidding documents and work contract Yes. Referred to in item 24 chapter A, Section 7 of the bidding document and annex 1 of the works contract Yes. Referred to in item 24 chapter A, Section 7 of the bidding document and annex 1 of the works contract Yes. Referred to in item 24 chapter A, Section 7 of the bidding document and annex 1 of the works contract

11 Proposed works Quang Tan Duc An Nghia Thang Waste water water Currently using septic tank for WC house. Currently using septic tank for WC house. Currently using septic tank for WC house. Solid waste treatment Solid wastes of the station mostly plastic syringe, packings of medicine are collected each day and then are burned by an incinerator Solid wastes of the station mostly plastic syringe, packings of medicine are collected each day and then are burned by an incinerator Solid wastes of the station mostly plastic syringe, packings of medicine are collected each day and then are burned by an incinerator Required environmental reports and approval for proposed works for receiving report is enclosed in appendix 4) A simple environmental protection plan is required according to the decree 18/2015/ND-CP. This plan had been prepared by Dak Nong PPMU and submitted to the DONRE for approval on 2 nd Dec 2015 (the note issued by Dak Nong DONRE for receiving report is enclosed in appendix 4) A simple environmental protection plan is required according to the decree 18/2015/ND-CP. This plan had been prepared by Dak Nong PPMU and submitted to the DONRE for approval on 2 nd Dec 2015 (the note issued by Dak Nong DONRE for receiving report is enclosed in appendix 4) A simple environmental protection plan is required according to the decree 18/2015/ND-CP. This plan had been prepared by Dak Nong PPMU and submitted to the DONRE for approval on 2 nd Dec 2015 (the note issued The relevant EMP is incorporated into bidding documents and work contract Yes. Referred to in item 24 chapter A, Section 7 of the bidding document and annex 1 of the works contract Yes. Referred to in item 24 chapter A, Section 7 of the bidding document and annex 1 of the works contract Yes. Referred to in item 24 chapter A, Section 7 of the bidding document and annex 1 of the works contract

12 Proposed works Thuan Hanh Eating Nam Dong Waste water water Currently using septic tank for WC house. Currently using septic tank for WC house. Currently using septic tank for WC house. Solid waste treatment Solid wastes of the station mostly plastic syringe, packings of medicine are collected each day and then are burned by an incinerator Solid wastes of the station mostly plastic syringe, packings of medicine are collected each day and then are burned by an incinerator Solid wastes of the station mostly plastic syringe, packings of medicine are collected each day and then are burned by an incinerator Required environmental reports and approval for proposed works by Dak Nong DONRE for receiving report is enclosed in appendix 4) A simple environmental protection plan is required according to the decree 18/2015/ND-CP. This plan had been prepared by Dak Nong PPMU and submitted to the DONRE for approval on 2 nd Dec 2015 (the note issued by Dak Nong DONRE for receiving report is enclosed in appendix 4) A simple environmental protection plan is required according to the decree 18/2015/ND-CP. This plan had been prepared by Dak Nong PPMU and submitted to the DONRE for approval on 2 nd Dec 2015 (the note issued by Dak Nong DONRE for receiving report is enclosed in appendix 4) A simple environmental protection plan is required according to the decree 18/2015/ND-CP. This plan had been prepared by Dak Nong PPMU and submitted to the DONRE for approval on 2 nd Dec The relevant EMP is incorporated into bidding documents and work contract Yes. Referred to in item 24 chapter A, Section 7 of the bidding document and annex 1 of the works contract Yes. Referred to in item 24 chapter A, Section 7 of the bidding document and annex 1 of the works contract Yes. Referred to in item 24 chapter A, Section 7 of the bidding document and annex 1 of the works contract

13 Proposed works Dak R Lap Waste water water In approved technical design, a WWTP with capacity of 100 m 3 /day shall be constructed. Solid waste treatment Medical solid wastes are treated on site by an incinerator. Required environmental reports and approval for proposed works 2015 (the note issued by Dak Nong DONRE for receiving report is enclosed in appendix 4) An Environmental Impact Assessment Report is required according to the decree 18/2015/ND- CP. This Report had been approved by Dak Nong Province Committee based the decree 878/QD-UBND on 18 June The relevant EMP is incorporated into bidding documents and work contract Yes. Referred to in item 24 chapter A, Section 7 of the bidding document and annex 1 of the works contract 16. The Loan Agreement requires that no works contract which involves environmental impacts will be awarded until DONRE has granted the final IEE approved by ADB in Sep 2013, relevant provisions of the EMP are integrated into the Works contract, and DONRE has issued the certificates of environmental protection or environmental impact assessment certificates. At the time of the review, the content of IEEs was approved by DONRE according to official letter No 2587/TNMT-BVMT issued by Dak Nong DONRE on 30 Oct For environmental certificates of 10 CHSs, it is expected to be obtained no later than 30 th Jan Indigenous peoples: Dak Nong province has 40 ethnic groups, accounting for about 31.23% ( people) of the province's population ( people) in which The Ede, M'nông and Ma are in place or the local peoples, and other ethnic groups have migrated during the last 30 years, such as Tay, Nung, Muong, Dao, Thai and Mong. The proposed works are located in 10 communes (Duc uyen, Quang Hoa, Quang Son, Quang Tan, Nghia Thang, Dak Buso, Duc An, Thuan Hanh, Eatling, Nam Dong) and Dak R Lap district. The service areas of the proposed works and the status of indigenous peoples in these areas are presented in table 4. Table 4. Indigenous peoples in the service areas of proposed works in Dak Nong province Proposed work locations Population Percentage of Indigenous peoples Number of ethnic groups Duc uyen % % of indigenous peoples is the Mo Nong, and others as the Tay, Nung Note

14 Quang Hoa % % of indigenous peoples is the Mo Nong, 10% is the Ma and others as the Tay, Nung Quang Son % % of indigenous peoples is the Mo Nong, and others as the HMong, Tay, Nung, Cao Lan, San, Diu Quang Tan % % of indigenous peoples is the Mo Nong, 16% is the Ma and others as the Tay, Nung Nghia Thang % % of indigenous peoples is the Mo Nong, and others as the Tay, Nung, Kho Me Dak Buso % % of indigenous peoples is the Mo Nong, and others as the Tay, Nung, Kho Me Duc An % % of indigenous peoples is the Tay, 40% is the Nung and others as the Kho Me Thuan Hanh % % of indigenous peoples is the Ma, 30% is the E De and others as the Dao, Muong, Tay, Cham Eatling % % of indigenous peoples is the Mo Nong, 30% is the Ma and others as Tay, Nung, Thai, Dao, Cham Nam Dong % 77 35% of indigenous peoples is the Ma, 20% is the Tay, 15% is the Nung and others as the Thai, Dao, Cham, Mo Nong.. Dak R lap % ethnic groups, 55% of District indigenous people is the Mo Nong, 15 % is the Ma and others as Tay, Nung, Thai, Dao, Kho me. 18. The project includes a significant proportion of ethnic groups amongst its beneficiaries in the targeted provinces, who are among some of the poorest and most marginalized households in Viet Nam. The ethnic group settlements are often situated in remote areas and have comparatively less access to basic services. Ethnic groups have higher infant mortality rates and maternal mortality ratio. Based on that fact, the project will prioritize interventions in areas with high ethnic group populations and hence have positive impact on ethnic group peoples (category B). A draft ethnic minority development plan (EMDP) has been developed for the project and approved by ADB in Apr 2013 including: (i) specific output and outcome targets for ethnic groups, with a particular focus on ethnic groups women; (iii) AWPs and budgets integrating specific ethnic groups-related activities; (iv) IEC materials specifically designed and translated for ethnic groups; (iv) recruitment of a social development specialist will support the integration of ethnic groups development issues into project activities; (v) inclusion of provisions for addressing ethnic groups issues in all guidelines, terms of reference, strategies and plans developed under the project; (vi) scholarships offered to candidate nurses originating from ethnic groups; and (vii) disaggregation of relevant monitoring and evaluation data by ethnicity.

15 19. According to item 8, Schedule 4 of the Loan Agreement 3038 VIE, the CPMU shall prepare and submit to ADB the final EMDP prior awarding any Works contract. To comply with this requirement, the CPMU has signed contract with a Gender and ethnic minority people s specialist who shall support the CPMU on the activities related to Gender and ethnic minority people issues including of preparing reports on updating compliance implementation of the EMDP. In Nov 2015, a draft updated EMDP had been submitted to ADB for clearance and also received comments from ADB to improve the quality of report. This draft report has been revising based on the ADB s comments and CPMU confirmed that these reports shall be submitted to ADB for approval before awarding any Works. IV. GRIEVANCE REDRESS MECHANISM AND IMPLEMENTATION ARRANGEMENT 20. APs can send any questions to implementation agencies about their rights in relation with land acquisition, environmental problems, compensation. Furthermore, APs will not be ordered to pay any fee for resolving their grievance and complaints at local levels and court. The following steps for grievance redress are established based on the Complaint Law no. 02/2011/QH13, dated 11/11/2011 and Degree No75/2012/NĐ-CP on November 20, A complaint can be handled maximum through three stages, if not solved, it can be sent to court as a final level. First Stage: Commune Peoples Committee (CPC) - An aggrieved AP may lodge his/her complaint before any member of the CPC through the residential group leader or directly to the CPC, in written or verbal form. It is incumbent upon the village chief to notify the CPC about the complaint. The CPC will meet personally with the aggrieved AP and will have 15 days to resolve the complaint. The CPC secretariat is responsible for documenting and keeping file of all complaints that it handles. Second Stage: District/Town People s Committee (DPC) - If after 15 days the aggrieved AP does not hear from the CPC, or if the AP is not satisfied with the decision taken on his/her complaint, the AP may bring the case, either written or verbal, to any member of DPC. DPC has 15 days to resolve the case. The DPC is responsible for documenting and keeping files of all complaints that it handles Third Stage: City People s Committee (City PC) - If 15 days the aggrieved AP does not hear from the DPC, or if the AP is not satisfied with the decision taken on his/her complaint, the AP may bring the case, either in writing or verbal, to any member of the City PC. The City PC has 15 days within which to resolve the complaint to the satisfaction of all concerned. The City PC secretariat is responsible for documenting and keeping file of all complaints that it handles. Final Stage: People s Court - If after 15 days following the lodging of the complaint with the City PC, the aggrieved AP does not hear from the City PC, or if he/she is not satisfied with the decision taken on his/her complaint, the case may be brought to the people s court. Subproject Implementation arrangement

16 21. Subproject implementation arrangement is related to many key agencies from national to localities. See the arrangement below: A. National Level 22. MOH is the Executing Agency for the Project and assures overall coordination, planning, implementation, and reporting. 23. During the implementation of the subproject, the CPMU under MOH has the following responsibilities: (i) providing overall planning, coordination, and supervision of the safeguard policies implementation; (ii) guiding the Land Fund Development Centre (LFDC) and the PPMUs to implement resettlement activities (if any) in accordance with the Loan Agreement; (iii) establishing a database of APs for each component, as well as for the Project as a whole; (viii) establishing procedures for ongoing internal monitoring and review of subproject level progress reports and for tracking compliance to project policies; (ix) establishing procedures for monitoring coordination between contractors and local communities and for ensuring prompt identification and compensation for impacts occurring during construction; (x) establishing procedures for the prompt implementation of corrective actions and the resolution of grievances (if any); B. Province Level 24. DakNong s PPC is responsible for resettlement, environmental and minorities poeple activities within its administrative jurisdiction. The main responsibilities of PPC include: (i) issuing decisions approving land valuations applied for compensation rates, allowances and other supports to APs, especially vulnerable groups, based on the principles of the RPs; (ii) Issuing decisions approving environmental certificates (iii) directing and supervising relevant provincial departments to implement effectively the environmental requirements (iv) authorize the district-level PCs to approve compensation, assistance and resettlement plans; (vi) directing the relevant agencies to settle APs complaints, grievances related to compensation, assistance and resettlement, environmental problems according to their lawprescribed competence; and (vi) directing the relevant agencies to examine and handle the violations in the compensation, assistance and resettlement domain. 25. The DakNong PPMU is responsible for safeguard implementation and internal monitoring. The main tasks of the PPMU include: (i) preparing, updating, and supervising safeguard requirement implementation; (ii) guiding the LFDC to implement all resettlement activities in compliance with the Project policy; and resolving any mistakes or shortcomings identified by internal monitoring to ensure that the objectives of the safeguard policies are met; and otherwise, to provide appropriate technical, financial and equipment support to the LFDC and Commune-level Inventory Working Groups; (iii) conducting, in combination with the LFDC and CPCs, information campaigns and stakeholder consultation in accordance with established project guidelines; (iv) implementing internal safeguard monitoring, establishing and maintaining AP databases in accordance with established project procedures and providing regular reports to the CPMU; and (vi) implementing prompt corrective actions in response to internal monitoring. C. District Level

17 26. The district PCs undertakes comprehensive management on compensation, assistance and resettlement. The DPCs are responsible to the PPC to report on progress, and the results of land acquisition. The DPC s primary task includes: (i) approving the schedule and monitoring the progress of land acquisition and resettlement implementation in compliance with the Project Policy; (ii) establishing the subproject s LFDC and Resettlement team and directing the LFDC and relevant district departments to appraise and implement the detailed compensation, assistance and resettlement; (iii) approving and taking responsibility before the law on the legal basis, and accuracy of the detailed compensation, assistance and resettlement options in the local area; approving cost estimates on implementation of compensation, assistance and resettlement work; (iv) taking responsibility for acquiring LURC, certificate on land owning rights of the AHs and individuals who will lose land and/or house; adjusting LURC for AHs and individuals who will lose land and/or house in accordance with the relevant authorization; (v) directing CPCs and relevant organizations on various resettlement activities; and (vii) resolving complaints and grievances of APs. 27. Land Fund Development Centers (LFDC), The main responsibilities of the LFDC are the following: (i) organizing, plan and carrying out compensation, assistance and resettlement activities; (ii) conducting the (Detailed Measurement Survey) DMS, consultation and disclosing project information, implementing income restoration program in coordination with various stakeholders; (iii) preparing the compensation plan and submiting it to the DPCs for approval; implementing compensation, assistance and resettlement alternatives; taking responsibility for providing the legal basis for the compensation, assistance and resettlement policy following the Project policy; (iv) leading and coordinating with the DPCs in the timely delivery of compensation payment and other entitlements to AHs; and (v) assisting the resolution of grievances. D. Commune Level 28. The CPC will assist the LFDC in their resettlement tasks. Specifically, the CPC will be responsible for the following: (i) in cooperation with district and commune level local mass organizations, mobilizing people who will be acquired to implement the compensation, assistance and settlement policy according to the Project policy; (ii) cooperating with the LFDC and working groups to communicate the reason for the acquisition to the people whose land is to be acquired; notifying and publicizing all resettlement options on compensation, assistance and resettlement which are approved by the DPCs; (iii) signing the Agreement Compensation Forms along with the AHs; (iv) assisting the resolution of grievances; and (v) actively participating in all resettlement, environmental activities and concerns. V. CONCLUSIONS AND RECOMMENDATIONS 29. As a result of the review of available documents, plans, technical designs and references provided by Dak Nong PPMU and other related agencies, this due diligence review concludes and recommends the following: The Subproject in Dak Nong would not have any involuntary resettlement impacts, all within the meaning of the ADB SPS. For land acquisition conducted in 2013 for the site of Quang Hoa Health Station, compensation for land and affected trees has been completed and no pending claims or issue related to compensation has been found, so no corrective action is needed related to land acquisition or resettlement.

18 Dak Nong Department of Natural Resources and Environment has granted the final approval of the IEE. It is recommended that the CPMU strictly monitors the implementation of IEE to ensure that the requirement shall be complied during construction and operation phase. 10 proposed works for CHSs of Dak Nong subproject have not obtained the environmental certificate as requirement of Vietnamese regulations. The certificate shall be granted no later than the end of Jan 2016 as the view of 10 environmental protection plans have been prepared and submitted to Dak Nong DONRE on 6 th Dec It is also recommended that the CPMU strictly monitors this to ensure that the requirement shall be complied before awarding any works contract and report to ABD when this requirement is done. The final report updating the activities related to ethnic minority that set forth in the draft EMDP shall be prepared and submitted to ADB for clearance and approval. The CPMU takes responsibility on implementation of this requirement, an ethnic minority specialist has been assigned to support the CPMU update the report to submit ADB for approval before awarding any works contract. At time of the DDR, not all conditions for awarding of civil works contracts have been meet that include (i) the environmental certificates for 10 CHSs and (ii) Clearance and approval by ADB of the final updated EMDP of the Project. The review and acceptance of these submissions by ADB shall be a condition of No objection of ADB for the award of civil works contracts.

19 Appendix 1 Involuntary Resettlement Impact Categorization Checklist Project: The second health care in the central highland project (HICH2) CATEGORY: C Probable Involuntary Resettlement Effects Yes No Not Known Remarks Involuntary Acquisition of Land Will there be land acquisition? Is the site for land acquisition known? The site for construction was identified in the existing Is the ownership status and current usage of land to be acquired known? hospital The site for construction was identified in the existing hospital Duc uyen, Quang Son, Thuan Hanh, Eatling, Nam Dong stations already have LURC Will easement be utilized within an existing Right of Way (ROW)? The owners of other stations are their respective communes Dak R Lap district hospital is holder of LURC Duc uyen, Quang Son, Thuan Hanh, Eatling, Nam Dong, the easement is within boundary of existing CHS. The others, the easement is within the land proposed for new construction CHSs Construction of WWTP and Upgrading of Dak R Lap Will there be loss of shelter and residential land use to land acquisition? Will there be loss of agricultural and other productive assets due to land acquisition? Will there be loss of crops, trees, and fixed assets due to land acquisition? within boundary of existing hospital

20 Probable Involuntary Resettlement Effects Yes No Not Known Remarks Construction of WWTP and Upgrading of Dak R Lap Will there be loss of business or enterprises due to land acquisition? Construction of WWTP and Upgrading of Dak R Lap Will there be loss of income sources and means of livelihoods due to land acquisition? Construction of WWTP and Upgrading of Dak R Lap Involuntary Restrictions on land use or on access to legally designated parks and protected areas Will people lose access to natural resources, communal facilities and services? Construction of WWTP and Upgrading of Dak R Lap If land use is changed, will it have an adverse impact on social and economic activities? Construction of WWTP and Upgrading of Dak R Lap Will access to land and resources owned by the communally or by the state be restricted? Construction of WWTP and Upgrading of Dak R Lap Information on Displaced Persons Any estimate of the likely number of persons that will be displaced by the Project? x No Yes Not applicable If yes, approximately how many?. Are any of the poor, female-headed households, or vulnerable to poverty risks? x No Yes Not applicable Are any displaced persons from indigenous or ethnic minority groups? x No Yes Not applicable

21 Appendix 2 Indigenous Peoples Impact Screening Checklist Project: The second health care in the central highland project (HICH) CATEGORY: B KEY CONCERNS (Please provide elaborations on the Remarks column) A. Indigenous Peoples Identification YES NO NOT KNOWN Remarks Are there socio-cultural group present in or use the project areas who may be considered as tribes (hill tribes, schedules tribes, tribal peoples), minorities (ethnic or national minorities) or indigenous communities in the project Construction area? and upgrading of 10 CHSs Are there national or local laws or policies as well as anthropological researches/studies that consider these groups present in or using the project area as belonging to ethnic minorities, scheduled tribes, tribal peoples, national Do such groups self-identity as taking part of a distinct social and cultural group? Do such groups maintain collective attachments to distinct habitats or ancestral territories and/or to the natural resources in these habitats and territories? Do such groups maintain cultural, economic, social, and political institutions distinct from the dominant society and culture? Such groups maintain cultural, economic, social, and political institutions distinct from the dominant society and culture Do such groups speak a distinct language or dialect? Such groups maintain cultural, economic, social, and political institutions distinct from the dominant society and culture Has such groups been historically, socially and economically marginalized, disempowered, excluded, and/or discriminated against?

22 KEY CONCERNS (Please provide elaborations on the Remarks column) YES NO NOT KNOWN Remarks Are such groups represented as Indigenous Peoples or as ethnic minorities or scheduled tribes or tribal populations in any formal decision-making bodies at the national or local levels? B. Identification of Potential Impacts Will the project directly or indirectly benefit or target Indigenous Peoples? Will the project directly or indirectly affect Indigenous Peoples traditional socio-cultural and belief practices? (e.g. childrearing, health, education, arts, and The people from indigenous communities will directly benefit from the Project in terms of improved quality of health cares The people from indigenous communities will directly benefit from the Project in terms of improved quality of health cares Will the project affect the livelihood systems of Indigenous Peoples? (e.g. food production system, natural resource management, crafts and trade, employment status) Are there socio-cultural group present in or use the project areas who may be considered as tribes (hill tribes, schedules tribes, tribal peoples), minorities (ethnic or national minorities) or indigenous communities in the project area?

23 Appendix 3. Official letters issued by Dak Nong DONRE for the approval final of the IEE

24

25 Approval letters for environmental certificates of construction of WWTP and Upgradin g Dak R Lap District Hospital

26

27 The note issued by Dak Nong DONRE for receiving 10 Environmental protection plan reports of the CHSs

28 Appendix 4 The minutes on Payment for land acquisition and compensation for construction of Quang Hoa Health Station on

29

30 people met Appendix 5. List of

31 Name Location Position Hoang Huu Hop Dak Nong PPMU Head of Finance Department of the PPMU Nguyen Huu Tho Dak Nong PPMU Officer of PPMU Tran Anh Duc Dak Nong PPMU Officer of PPMU Truong Thi Minh Thuan Hanh Health Officer of the station Khuyen Station Nguyen Thi Thanh Nga Quang Hoa Health Head of the station Station Tran Duc Dai District Health Center Deputy of the Center Vuong Thi Non Quang Hoa commune Local People Vo Thi Tien Duc uyen Health Officer of the station Station Mai Thi Huong Duc uyen Health Officer of the station Station Nguyen Van Thanh Quang Son Health Head of the station Station Tran Thi Viet Quang Son commune Local people Dak Buso Dak Buso Health Station Officer of the station Nguyen Van Hiep Quang Tan Health Station Officer of the station Nguyen Van Cuong Nam Dong Health Station Officer of the station Hoang Thi anh Duc An Health Station Officer of the station Hoang Thi uyen Duc An town President of the town Le Mai Tuong Nghia Thang Health Station Head of the station